Associations of Healthy Lifestyle With All-Cause and Cardiovascular Disease Mortality in Individuals With Cardiovascular-Kidney-Metabolic Syndrome: Two Prospective Cohort Studies.

BACKGROUND

Cardiovascular-kidney-metabolic (CKM) syndrome poses a major health risk. This study assessed the impact of a healthy lifestyle on all-cause and cardiovascular disease (CVD) mortality in CKM individuals.

METHODS

We analyzed 306 831 and 9823 CKM individuals from UK Biobank and NHANES (2007-2018). A healthy lifestyle score was created based on seven factors: no current smoking, moderate drinking, healthy diet, regular physical activity, adequate sleep, low sedentary behavior and appropriate social connection. Primary outcomes were all-cause and CVD mortality from linked health records and death registries.

RESULTS

Cox regression models showed that higher lifestyle scores were associated with reduced risks of all-cause (hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.80-0.82) and CVD mortality (HR: 0.82, 95% CI: 0.80-0.84) in UK Biobank. In NHANES, higher scores were associated with 15% (95% CI: 0.80-0.90) and 11% (95% CI: 0.81-0.99) lower mortality risks. Both regular physical activity (HRs: 0.85 and 0.89 for UK Biobank, 0.76 and 0.73 for NHANES) and low sedentary behavior (HRs: 0.85 and 0.91 for UK Biobank, 0.79 and 0.67 for NHANES) were related to reduced mortality risks (p < 0.05). Participants with non-advanced CKM syndrome and a favorable lifestyle had the lowest mortality risks compared to those with advanced CKM syndrome and an unfavorable lifestyle.

CONCLUSION

A healthy lifestyle, particularly regular physical activity and low sedentary behavior, was significantly associated with lower all-cause and CVD mortality in individuals with CKM syndrome. These associations were stronger in the early stages, highlighting the importance of timely and targeted lifestyle interventions.